title: Basis of monitoring central blood pressure and hemodynamic parameters by peripheral arterial pulse waveform analyses.
abstract: In hypertension clinics, central blood pressure (CBP) should be estimated, instead of directly measured, by the "signal processing" of a noninvasive peripheral pressure waveform. This paper deals with the data obtained in our three separate studies focusing on a major estimation method, i.e., radial artery late systolic shoulder pressure (rSBP2)-based CBP estimation. Study 1: Using a wave separation analysis of precise animal data of pressure wave transmission along the upper-limb arteries, we first demonstrate that pulse pressure amplification is largely attributable to local wave reflection alone. Study 2: A frequency component analysis of simultaneously recorded human central and radial artery pressure waveforms showed a predominance of lower (1st+2nd) harmonic components in determining the central augmentation peak amplitude. The features of a central pressure waveform, including its phase property, may contribute to the less-altered transmission of augmentation peak pressure to rSBP2. Study 3: Comparisons of noninvasive rSBP2 with direct or estimated central systolic blood pressure (cSBP) revealed broad agreement but also augmentation-dependent biases. Based on the features of the biases as well as the counterbalanced relationship between pulse pressure amplification and the transmission-induced alterations of augmentation peak amplitude observed in Study 2, we propose an improved cSBP estimate, SBPm, the simple arithmetic mean of rSBP2 and peripheral systolic blood pressure.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Miyashita
authors.forename: Shin-ichiro
authors.initials: S
authors.lastname: Katsuda
mesh_terms: D000818:Animals; D050197:Atherosclerosis / Q000503:physiopathology; D001794:Blood Pressure; D001795:Blood Pressure Determination / Q000379:methods; D005583:Fourier Analysis; D006801:Humans; D063177:Pulse Wave Analysis; D011817:Rabbits; D017534:Radial Artery / Q000503:physiopathology*